Nursing educators' experiences of cultural competence in the nursing education program: A qualitative descriptive study.

BACKGROUND: To meet the population's increasing diversity and the health system's needs, it is necessary to prepare nursing schools to produce culturally qualified students. PURPOSE: This study aimed to extract the experiences of nursing educators about the cultural competence of nursing students. METHOD: In this qualitative descriptive study, data were collected through in-depth, semi-structured interviews with 15 nursing educators affiliated with three medical sciences universities in southeastern Iran. Purposive data sampling and analysis were performed using Graneheim and Lundman's conventional content analysis methods. RESULTS: One main theme, 5 categories, and 18 subcategories were extracted. The main theme was "cultural equality, the essence of care and education". Categories included "Toward culturally-based caring and education", "Charter of cultural rights", "The need for cultural competence facilitators", "Cultural exposure", and "Modifying the curriculum policies". CONCLUSION: This study shows that nursing educators strive to take into account students' cultural competence, even though cultural competence is not explicitly integrated into nursing curricula. The acquisition of cultural competence requires multifaceted changes in education, in clinical centers, and in the creation of cultural infrastructure.

Innovative cultural care training: the impact of flipped classroom methods on critical cultural competencies in psychiatric nursing: a quasi-experimental study.

INTRODUCTION: Healthcare systems are encountering a growing number of diverse and multicultural clients due to globalization and migration. To effectively address the challenges associated with cross-cultural interactions, nurses require a comprehensive framework of critical cultural competencies. One potential approach to enhancing these competencies in mental health care settings is to use innovative methods such as the flipped classroom in cultural care training programs. This study evaluated the effect of using the flipped classroom method in cultural care training on the critical cultural competencies of nurses working in a psychiatric hospital. METHODS: This quasi-experimental study involved 70 nurses working in a psychiatric hospital affiliated with the Kerman University of Medical Sciences in southeastern Iran. Through random sampling, the nurses were allocated into two groups of intervention (n = 35) and control (n = 35). The intervention group participated in a cultural care training program using the flipped classroom method, which consisted of four sessions conducted over a four-week period. To evaluate the nurses' critical cultural competence, the Almutairi's Critical Cultural Competence Scale was administered before the training and again one month later. RESULTS: The study findings indicated no significant differences in the scores of critical cultural competencies between the intervention group (4.53 ± 0.64) and the control group (4.73 ± 0.42) during the pre-test stage (t = 1.53, p = 0.13). Both groups had a similar perception of critical cultural competencies, which was not particularly positive. However, in the posttest stage, the intervention group (5.33 ± 0.49) demonstrated a significant increase in critical cultural competencies compared to the control group (4.75 ± 0.44) (t = 5.14, p = 0.001). CONCLUSION: The study results indicated that the use of the flipped classroom method in the cultural care training program effectively enhanced the critical cultural competencies of nurses. Given the importance of cultural care in both physical and psychiatric care settings for multicultural clients, it is crucial for nurses to receive ongoing in-service education that utilizes innovative and active methods such as the flipped classroom.

The effectiveness of communication skills training on professional performance and quality of work life of pre-hospital emergency medical staff: An experimental study in Iran.

AIM: Communication skills are one of the components that influence the performance of pre-hospital emergency staff who provide services to patients. This study aimed to determine the effectiveness of communication skills training on the professional performance and quality of work life of pre-hospital emergency staff. METHODS: This experimental study with pretest-posttest design was conducted on 150 pre-hospital emergency staff in Iran from March 2022 to May 2023. The participants were randomly assigned into two control (n = 75) and experimental (n = 75) groups. The intervention included 4 sessions (3 h each) of communication skills training, weekly. The data gathering scales were Stamm's quality of work life questionnaire and Patterson's job performance questionnaire, which were used at start point, 4 and 8 weeks after that. RESULTS: The mean score professional performance in experimental group increased significantly to 42.4 ± 0.70 in the second stage and to 44.5 ± 0.55 in the third stage (P < 0.05). The mean score of the quality of work life was also 96.9 ± 0.9 and 99.8 ± 0.9 in the 4th and 8th weeks after the intervention, which was significantly more than control group (P < 0.05). CONCLUSIONS: The results showed the communication skills training improves professional performance and increases the quality of work life of pre-hospital emergency staff.

Schizophrenia: jinn, magic or disease? Experiences of family caregivers of patients with schizophrenia in Baloch ethnicity.

BACKGROUND: Cultural and religious beliefs are effective on people's attitudes towards schizophrenia and their help-seeking behaviors. This study aimed to explain the experiences of family caregivers of patients with schizophrenia in Baloch ethnicity. METHODS: This is a qualitative study with conventional content analysis approach. Purposive sampling was used and 21 participants, including family caregiver for patients with schizophrenia, a psychologist, a prayer-writer, and a normal person were interviewed in Sistan and Balochistan province in the southeast of Iran. Qualitative data were analyzed by Granheim and Lundman method. RESULTS: One main theme, three categories, and 10 Sub-categories were extracted from analysis of interviews. "Immersion in the cultural beliefs" was the main theme of the study with categories of "Belief in the superstitious and supernatural nature of the psychological disease", "Superstitious beliefs, an attempt to free the patient", and "Conflict between cultural beliefs and science". CONCLUSIONS: Help-seeking behaviors of family caregivers in Baloch ethnicity are influenced by their religious, superstitious, and cultural beliefs. Psycho-education should be part of all mental health education programs in these communities, as delays in treatment worsen the prognosis of people with schizophrenia. Training the medical staff to consider the culture, religion and therapeutic preferences of the Baloch people can be effective in advancing the goals. In addition, local influencers should stress the importance of health care alongside harmless local remedies.

Explaining the educational challenges in the path of cultural competence: The experiences of Iranian nursing students.

BACKGROUND: Cultural care is necessary for healthcare settings due to the presence of culturally diverse clients. Nursing students face different challenges in the path of cultural competence. PURPOSE: This study aimed to characterize nursing students' educational challenges in achieving cultural competence. METHOD: Data were collected through interviews with 14 nursing students, 2 faculty members, and 2 nurses working in educational and clinical centers affiliated to Kerman University of Medical Sciences in southeastern Iran. The Graneheim and Lundman approach was used to conduct purposeful sampling and analyze data. RESULTS: Data analysis revealed the theme of nurses' educational challenges with cultural competence with four major categories: the neglect of cultural competence in educational approaches, the lack of importance of culturally congruent care in clinical settings, poor intercultural communication, and insufficient skill in cultural humility. CONCLUSION: The present study shows numerous barriers to nursing students' cultural competence, which impair their learning and care for culturally diverse patients.

Family achievements in struggling with schizophrenia: life experiences in a qualitative content analysis study in Iran.

BACKGROUND: The challenges of living with and taking care of a patient with schizophrenia can lead to positive changes depending on the experiences and reactions of family caregivers. Such changes may directly affect the family performance and the patient's recovery stage. Present study aimed to explain the positive experiences reported by family caregivers of patients with schizophrenia. METHODS: The present study is a qualitative study of content analysis. Data were collected using semi-structured and in-depth interviews with 15 family caregivers of patients with schizophrenia referring to one of the psychiatric hospitals in Zahedan, Southeast part of Iran. Purposive sampling method was applied and data analysis was conducted using conventional content analysis proposed by Graneheim and Lundman. RESULTS: Data analysis created a theme entitled "family achievements in struggling with schizophrenia". This theme included four categories including Developing positive personality traits in family members, Strengthening family ties, developing insight into the life, and social mobility. CONCLUSIONS: The results provided insights that the experience of taking care of patients with schizophrenia led to positive consequences for family caregivers. Thus, it is recommended that psychiatrists or consultants help families rely on positive experiences and share these experiences with families with a newly-suffered patient.

Does attachment style predict quality of life in youth? A cross-sectional study in Iran.

The attachment can be considered as a specific behavioral pattern that is critical to healthy growth in most communities. Medical students are exposed to high levels of psychological stress while being equipped with lower levels of resilience. This study aims to determine the relationship between attachment style and the quality of life of medical students. In this cross-sectional correlational study, 150 students of Iranshahr University of Medical Sciences in 2018 were selected based on convenience sampling with consideration of inclusion criteria. Revised Adult Attachment Scale (RAAS) and Quality of life questionnaire (SF- 36) were used as data gathering scale. The data were analyzed with SPSS ver.19 using the Pearson correlation coefficient and linear regression. The participants' mean quality of life score was 74.2 ± 16.7. In attachment style, 48.7% of the participants had secure attachment, 26.0% avoidant attachment, and 25.0% ambivalent attachment. The results of this study indicated a significant direct correlation between the quality of life scores and secure attachment style (p value <0.000). Also, there was a significant inverse correlation between the quality of life score and ambivalent attachment style (p value <0.000). Attachment style predicted students' quality of life. Moreover, the role of Attachment style highlighted potential areas for intervention to improve medical student well-being and provide a foundation for longitudinal follow-up.

Organizational Learning: The Missing Link to Promote Nurses' Professional Self-Efficacy.

INTRODUCTION: Nurses are one of the important sources of organizational learning, and the main elements of knowledge transfer in hospitals. They can play a major role in the process of organizational learning. One of the factors affecting nurses' learning is self-efficacy. OBJECTIVE: The aim of this study was to evaluate the association between organizational learning and professional self-efficacy among nurses. METHODOLOGY: A cross-sectional study was conducted among 150 nurses in Ali Ibn Abitaleb Hospital in Zahedan City, Iran in 2018, selected by simple randomized sampling. Tools used were the Neefe Organizational Learning Questionnaire (Neefe, 2001), and Riggs and Knight's Self-Efficacy Questionnaire (1994). RESULTS: The results showed a significant positive correlation (p <0.05) between self-efficacy scores and the organizational learning dimensions of systems thinking, team learning, and shared vision. Linear regression analysis showed that these three dimensions of organizational learning predicted 16.1% of the professional self-efficacy variations. DISCUSSION: Organizational learning has a direct relationship with nurses' professional self-efficacy. Promotion of organizational learning characteristics in hospitals will enhance nurses' self-efficacy.

Frequency of Maternal Mortality in Urban and Rural Areas of Iranshahr County (Southeast of Iran) in 2009-2013: A Retrospective Study.

INTRODUCTION: Maternal mortality is one of the threatening factors of human life and the overall status index of women's health in any society. Death of a mother causes irreversible damage to a family and a society. This study aims at examining the causes of maternal mortality in urban and rural areas. AIM: The purpose of this study was to determine the frequney and causes of maternal mortality in urban and rural areas in southeast of Iran in 2009-2013. MATERIALS AND METHODS: This was a retrospective descriptive study and its research population includes the entire pregnant woman who died in Iranshahr County between April 2009 and March 2013. An eight-section questionnaire was used for collecting data. The first section was based on the hospital records of pregnant woman including mother's demographic data and the following sections were completed based on their health records. RESULTS: The frequency of maternal mortality during birth in the study period was 34 (of 4857). The study individuals were between 13 and 40-year-old with the mean age of 30±6.4. Maximum maternal mortality occurred in 2012. Haemorrhage was the most common cause of maternal death (38.2%). CONCLUSION: As haemorrhage was the most common cause of death of pregnant women in this study, it seems necessary to improve care for woman and reduce haemorrhage and its complications during pregnancy period.

Effect of Triage Training on Concordance of Triage Level between Triage Nurses and Emergency Medical Technicians.

INTRODUCTION: The transfer of care occurs frequently between emergency medical technicians and emergency ward nurses during which emergency medical technicians transfer the patients from the society to the hospital. This transfer of care often occurs under crowded conditions and in high acuity which would pave the way for a disruption of communication. AIM: This study aimed to investigate the effect of training Emergency Severity Index (ESI) triage on concordance of triage level between emergency medical technicians and triage nurses. MATERIALS AND METHODS: This interventional study was conducted on all triage nurses and emergency medical technicians in Iranshahr City in winter of 2014. Five triage nurses and 30 emergency medical technicians were included into the study using census. To collect data, Personal Information Form (PIF) and ESI Triage Criterion were used. During the project implementation, patients were separately classified before and after triage training by emergency medical technicians and triage nurses. To analyse the data, kappa coefficient under SPSS 16 statistical software was used. RESULTS: According to the study results, Cohen's kappa concordance coefficient showed that triage concordance between emergency medical technicians and triage nurses before training was 0.20 which was at an unfavorable level. After training, Cohen's kappa concordance coefficient reached 0.62, which showed a desirable level of concordance as well as a significant difference after training. CONCLUSION: It is recommended to train and use common triage system to facilitate transfer or delivery of care between emergency medical technicians and triage nurses.

Effect of Communication Skills Training on the Burnout of Nurses: A Cross-Sectional Study.

INTRODUCTION: One of the factors influencing the burnout of nurses is their difficult and complicated relations with patients and other members of the medical team. Therefore, it is necessary that nurses to be trained on communication skills. AIM: The present research aims to study the effect of communication skills training on the burnout of nurses. MATERIALS AND METHODS: The present research was an experimental study using pretest-posttest method. The subjects included 60 nurses working in Khatamolanbia Hospital in Iranshahr, Sistan and Baluchestan Province, Iran. The subjects were randomly divided into two groups. The required data and information were collected using Jackson and Maslach Burnout Inventory which was filled out by subjects in three steps including before the intervention, at the end of the second session, and one month after the intervention. The intervention included training on communication skills which was carried out for the intervention group as a 2-day workshop for 8 hours within a week. RESULTS: The findings showed that the mean score of frequency and intensity of burnout in the intervention group before the intervention, at the end of the intervention, and one month after the intervention was 39.3±6.2 and 61.1±8.0, 37.5±4.6 and 58.8±7.6, and 34.2±4.4 and 54.6±7.0, respectively. These changes suggest a significant decreasing trend (p=0.01). On the other hand, mean scores of burnout in the control group showed no significant difference in three steps (p<0.05). CONCLUSION: Since communication skills training is an effective and inexpensive way for reducing the burnout among nurses, it is recommended that this approach to be taken into account by managers in order to reduce the burnout among nurses and improve the quality of healthcare services provided by them.

Effect of Eye Movement Desensitization and Reprocessing (EMDR) on Depression in Patients With Myocardial Infarction (MI).

BACKGROUND: Coronary heart disease is the most important cause of death and inability in all communities. Depressive symptoms are frequent among post-myocardial infarction (MI) patients and may cause negative effects on cardiac prognosis. This study was conducted to identify efficacy of EMDR on depression of patients with MI. METHODS: This study is a clinical trial. Sixty patients with MI were selected by simple sampling, and were separated randomly into experimental and control groups. To collect data, demographic questionnaire and Beck Depression Questionnaire were used. In experimental group, EMDR therapy were performed in three sessions alternate days for 45-90 minutes, during four months after their MI. Depression level of patients was measured before, and a week after EMDR therapy. Data were analyzed using paired -t- test, t-test, and Chi-square. RESULTS: The mean depression level in experimental group 27.26±6.41 before intervention, and it was 11.76±3.71 after intervention. Hence, it showed a statistically significant difference (P<0.001). The mean depression level in control group was 24.53±5.81 before intervention, and it was 31.66±6.09 after intervention, so it showed statistically significant difference (P<0.001). The comparison of mean depression level at post treatment, in both groups showed statistically significant difference (P<0.001). CONCLUSION: EMDR is an effective, useful, efficient, and non-invasive method for treatment and reducing depression in patients with MI.